Our Summary

This study aimed to find out what Canadian pediatric urologists, surgeons, and pathologists think about the routine examination of hernia sacs after repair surgery for inguinal hernias and hydroceles in children. They were asked to participate in a survey from June 2019 to January 2021.

The results showed that most of the urologists and surgeons who responded didn’t regularly send hernia sacs for examination after surgery. They also felt that these examinations weren’t very useful. Among those who did send hernia sacs for examination, the majority did not get results that changed how they treated their patients.

However, the pathologists who responded had mixed opinions on this issue. Most of them only did a basic examination, unless the surgeon asked for a more detailed one or if they noticed something unusual. Most of them reported finding significant abnormalities, such as issues with the vas deferens and spermatic cord.

Currently, there are no guidelines based on evidence about whether hernia sacs should be examined after these kinds of surgeries. The study recommends that future guidelines should focus on identifying specific cases where an examination might be useful. It also suggests that more research is needed to figure out if there are certain patients who are more likely to have significant abnormalities and could benefit from an examination.

The study had a limitation - the response rate from the members of the Canadian Association of Pediatric Surgeons was low, possibly due to the COVID-19 pandemic.

In conclusion, while most pediatric urologists and surgeons didn’t see much value in examining hernia sacs after surgery, about half of the pathologists did. The study suggests that future research should focus on creating evidence-based guidelines that consider these different viewpoints.

FAQs

  1. What were the main findings of the study on examining hernia sacs after pediatric inguinal hernias and hydroceles surgeries?
  2. What did the pathologists report in the study about examining hernia sacs after pediatric hernia repair surgery?
  3. What were the recommendations of the study regarding the examination of hernia sacs after pediatric hernia repair surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about pediatric hernia repair is to discuss with their healthcare provider the necessity of examining the hernia sac after surgery. While some healthcare providers may not routinely send hernia sacs for examination, others may find it beneficial in identifying any significant abnormalities that could impact future treatment. It’s important to have an open discussion with their healthcare provider about the potential benefits of post-operative examination to ensure the best care for their child.

Suitable For

Pediatric patients who have undergone hernia repair surgery are typically recommended to have their hernia sacs examined post-operatively. This study suggests that while most urologists and surgeons may not routinely send hernia sacs for examination, there may still be value in doing so, especially if significant abnormalities are found that could impact patient care. Therefore, patients who may benefit from a post-operative hernia sac examination could include those with unusual symptoms or presentations, those with a history of complications, or those who may have a higher risk of underlying abnormalities. Ultimately, individual patient factors should be considered when determining whether a post-operative hernia sac examination is warranted.

Timeline

Before pediatric hernia repair:

  • Patient experiences symptoms such as a bulge in the groin area, pain or discomfort, and sometimes vomiting or irritability
  • Consultation with a pediatric surgeon to confirm the diagnosis of a hernia and discuss treatment options
  • Pre-operative preparation including fasting, anesthesia consultation, and any necessary tests or imaging

After pediatric hernia repair:

  • Patient undergoes surgery to repair the hernia, typically performed as an outpatient procedure under general anesthesia
  • Post-operative recovery period with instructions for pain management, wound care, and activity restrictions
  • Follow-up appointments with the surgeon to monitor healing and address any concerns or complications
  • Some patients may undergo a routine examination of the hernia sac after surgery, although the necessity and value of this practice are debated among healthcare professionals
  • Overall, most patients experience a successful recovery with a low risk of complications.

What to Ask Your Doctor

Some questions a patient should ask their doctor about pediatric hernia repair:

  1. Should the hernia sac be sent for examination after surgery? Why or why not?
  2. What are the potential risks or benefits of examining the hernia sac after surgery?
  3. How common are significant abnormalities found in hernia sac examinations?
  4. If an abnormality is found, how might it impact my child’s future health or treatment?
  5. Are there certain factors that would make it more likely for my child to benefit from a hernia sac examination?
  6. Are there any specific symptoms or signs to watch out for after surgery that may indicate a need for further examination?
  7. What are the current guidelines or recommendations regarding hernia sac examination after pediatric hernia repair?
  8. Are there any ongoing research studies or developments in this area that we should be aware of?
  9. How will the results of a hernia sac examination, if performed, affect my child’s follow-up care or long-term health monitoring?
  10. Is there anything else I should know or consider regarding hernia sac examination after pediatric hernia repair?

Reference

Authors: Lee MJ, Kim JK, Fervaha G, Chua ME, Brindle ME, Terry J, Koyle MA. Journal: J Pediatr Urol. 2022 Jun;18(3):335-339. doi: 10.1016/j.jpurol.2022.03.005. Epub 2022 Mar 14. PMID: 35367145